Mobile Motivational Physical Activity Targeted Intervention

More than 50% of older persons with osteoarthritis (OA) experience disrupted sleep and
insomnia symptoms of difficulty falling asleep, awakening during the night, and awakening too
early and being unable to fall back to sleep. Because OA pain has been implicated in sleep
problems and because physical exercise interventions have been found to improve pain and
sleep quality, staying physically active during the daytime is likely advantageous in terms
of improving sleep. Physical exercise interventions with a duration between 10 and 16 weeks
have been shown to improve quality of sleep in older adults with self-reported disrupted
sleep. Unfortunately, recent reports show that older adults with OA are mainly sedentary and
few meet national guidelines for recommended amounts of daily physical activity. A
self-management intervention that integrates use of mobile technology to prompt older adults
to be physically active, provides ongoing monitoring of the amount of their physical activity
and includes self-efficacy enhancements is a novel non-pharmacological intervention both for
prevention and treatment of sleep deficiency in persons with OA.

The proposed study will involve delivery of automatic physical activity-focused text
messages, a novel sleep self-management diary (SleepTight) and motivational interviewing in
participants with OA of the hip or knee (most commonly affected joints). The purpose of this
Project is to pilot test a new self-management program: MobMPATI, a multidimensional,
tailored intervention for sleep deficiency in for older adults with OA. The specific aims are
to:

1. Test the acceptability of MobMPATI for older adults with OA and poor sleep quality as a
manifestation of sleep deficiency.

2. Test the feasibility of implementing MobMPATI for older adults with OA, as well as
collecting electronic data from the sample.

3. Explore pre/posttest changes in self-efficacy, motivation and sleep deficiency measures
[total sleep time (TST) and sleep efficiency (SE)] with the MobMPATI intervention.

This study will provide feasibility/acceptability and preliminary data necessary for a larger
clinical trial of MobMPATI intervention to encourage physical activity and reduce sedentary
behavior in older adults with OA as a way of reducing sleep deficiency. Preliminary testing
of the intervention will indicate what measures are more sensitive in promoting self-efficacy
and motivation so that a smaller number of outcomes could be monitored to reduce participant
burden. This study is the first step in this innovative program of research. The knowledge
gained will provide data on the benefit of a potentially cost-effective intervention that
could be implemented on a large scale to improve health of older adults with OA.